Tips for helping the family cope with critically ill patients

A significant role for the nurse is orientating a patient's family to the critical care unit. Here are some useful tips for dealing with family members of critically ill patients.

The environment
If it the first time the relatives have visited it is a good idea to greet the family at the door and explain to them what to expect. Ensure the relatives can see the patient by seating them on the side the patient is lying and lowering the bed if necessary. Make the relatives feel welcome and not a hindrance by introducing yourself and spending time with them. Explain what the equipment is for and what alarms mean. Explain the infection control measures.

Please touch
Let family members know that it's okay to touch the patient. Many are afraid to touch a critically ill loved one for fear of interfering with monitoring equipment or invasive lines. Let them know if there are any special considerations when touching the patient.

How's the weather?
Many family members spend their visitation time looking at equipment in the room and asking the patient questions such as, 'Are you in pain?' Encourage them to focus on the patient, not necessarily their pain or surroundings. You may have to explain on a daily basis how they should behave depending on changes in condition, for example, if the patient is agitated they should be calm and reassuring and if
the patient is apathetic they should be upbeat and positive.

Let family members know how to be visitors.
The patient wants to hear about the outside world - not reminders that they're ill and hospitalised. They may want to hear about other family members, the family pet and who won the latest football match. It
is important to encourage and motivate the patient and remind them about what they have to get better for.

One at a time, please
Ask the family to appoint one spokesperson for the group. This is especially important when families are large. The spokesperson is the person who should call the unit for updates on the patient's condition. The spokesperson can then spread the word to the rest of the family. It may also be helpful to identify a primary nursing contact for the family.

Should they stay or should they go?
Allow family members to stay at the patient's bedside when appropriate. For example, a patient may require constant monitoring to keep them from trying to climb out of bed. If a family member is available to stay with such a patient, the use of sedatives and restraints could be avoided.

On the other hand, some patients appear to be agitated and have adverse changes in their vital signs when certain family members are present. Remember: Your first role is to be a patient advocate and to do what's best for the patient. Ask them whether they want to have visitors and whom they want to visit. If having a family member is best for the patient, then allow the visitor to stay. Many units have open visitation policies but this should also be matched with needs of the relatives who should not be made to feel guilty if they find visiting difficult.

Ensure support
Ensure that support services are available to family members if they need them. If they belong to a particular church, offer to call someone if needed. Most facilities provide spiritual care for families if they
request it.

Practical help
Providing information about rest facilities, patient accommodation, parking availability and on-site shops and amenities all help to make the relatives’ experience in critical care less distressing.

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